Provider Demographics
NPI:1932589462
Name:CAIN, KRISTA JEAN (MA, MPH, LMHC)
Entity type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:JEAN
Last Name:CAIN
Suffix:
Gender:F
Credentials:MA, MPH, LMHC
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:JEAN
Other - Last Name:BRINGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MPH, LMHC
Mailing Address - Street 1:515 PUERTA CT
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6822
Mailing Address - Country:US
Mailing Address - Phone:407-205-2574
Mailing Address - Fax:
Practice Address - Street 1:7758 WALLACE RD STE VI
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-205-2574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health